Aneurysms and dissections of the thoracic and abdominal aorta are the most common diseases of the aortic tree and are associated with a high morbidity and mortality caused by bleeding in case of rupture or malperfusion of vital organs in case of dissection. The knowledge of epidemiology, pathophysiology and clinical presentation allows the most appropriate diagnostic evaluation in both acute and chronic situations. Ultrasound is the ideal and most cost-effective imaging modality for screening and follow-up investigations of abdominal aortic aneurysms. Contrast-enhanced computed tomography is the most appropriate imaging for aneurysm of the thoracic aorta or for acute events with rupture or dissection.
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The most frequent traumatic experiences in Switzerland are accidents and violent acts with a lifetime prevalence of 5 and 2%, respectively. Approximately 15% of survivors develop a posttraumatic stress disorder (PTSD) in the aftermath of the traumatic event. PTSD is often accompanied with functional impairment. Consequently, PTSD plays a major role in insurance medicine. Forensic assessments often induce substantial stress in PTSD clients because the forensic setting may trigger traumatic feelings of fear and helplessness. Reliability of PTSD diagnosis and working capacity among evaluators are often insufficient. Here, we provide strategies for establishing a safe forensic relationship with traumatised clients. We propose a systematic approach to evaluating psychopathology, functional impairment and working capacity. We also address potential novel procedures such as a psychophysiological diagnostic laboratory test and limitations that need to be overcome in order to improve reliability and validity in forensic PTSD assessment.
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The successful road to neuro-otology starts with an appreciation of phenomenology, in particular eye movements. Some physiological facts and "laws"concerning the vestibulo-ocular reflex (VOR) constitute the basis for accurate neuro-otological diagnosis. These include the frequency-dependence of the VOR, the concept of vestibular resting rate, the push-pull configuration of the semicircular canals, Ewald's second law, Alexander's law, and the inherent imbalance of vertical eye position. Only when one is able to distinguish normal from disordered ocular motor behaviour, and understands the underlying physiological mechanisms, is it possible to identify the affected neuro anatomical structures and establish accurate diagnoses.
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